Efficacy of Bedside Respiratory Muscle Training in Patients With Stroke

Abstract

Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis

“…Of these, 754 were excluded by irrelevancy and 46 were full-text revised. Finally, nineteen studies aimed to assess the effectiveness of RMT on pulmonary function and functional capacity variables in patients with stroke were included in the meta-analysis [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Figure 1 shows the flow of study selection.…”

“…The subgroup analysis by type of intervention showed a slightly greater effect in the pooled of the studies that performed only IMT [ES= 0.89 (95% CI: 0.19 to 1.58; I 2 = 66.3%, p = 0.018)] compared with the IMT/EMT subgroup [ES= 0.38 (95% CI: 0.06 to 0.69; I 2 = 0.0%, p = 0.650)]. The FVC was analysed in nine studies [19,23,25,27,29,32,34,36,37]. The pooled ES was 0.32 (95% CI: 0.06 to 0.58; I 2 = 0.0%, p = 0.507) ( Figure 3).…”

“…Other pulmonary function parameters such as PEF and the strength of inspiratory and expiratory muscles (MIP and MEP) were analysed in the studies included. Seven studies showed results about PEF and the pooled estimated ES was 0.48 (95% CI: 0.20 to 0.77; I 2 = 0.0%, p = 0.823) (Figure 4) [20,23,27,33,34,36,37], nevertheless, the subgroup analysis displayed a statistically significant ES in the IMT/EMT group (ES = 0.55; 95% CI: 0.17 to 0.92) but not in the IMT group (ES = 0.40; 95% CI: −0.04 to 0.84).…”

“…The pooled ES of RMT interventions on dyspnea was 0.47 (95% CI: −0.30 to 1.23; I 2 = 77%, p = 0.002) (Figure 8), showing a positive trend of improvement which was not statistically significant. The MBI [19,23,29] and BBS [23,24,27] were only evaluated in three studies. In both, the RMT interventions did not show a statistically significant improvement (MBI: 0.22 (95% CI: −0.31 to 0.75; I 2 = 37.6%, p = 0.201; and BBS: 0.06 (95% CI: −0.37 to 0.49; I 2 = 0.0%, p = 0.953).…”

Effectiveness of an early mobility protocol for stroke patients in Intensive Care Unit

“…38 The finding of significant improvements in pulmonary functions )FVC, FEV1( post-treatment is similar to previous studies. 39 Yoo et al 39 employing a mobility protocol for patients with respiratory failure in ICU showed that both ICU stay and hospital stay were shortened.Sprenkle and Michael 40 found that early mobilization and upright sitting was favorable for patients admitted to neurological ICUs. They stated that mobilization in neurological ICUs could reduce length of stay, hospital acquired infections, and ventilator associated pneumonia.…”